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Research ArticleArticles

COVID-19 Personal Protective Equipment in the Home: Navigating the Complexity of Donning and Doffing

Brian Kerley, Lana Tan, Denise Marshall, Cindy O’Neill, Anne Bialachowski and José Pereira
The Annals of Family Medicine February 2021, afm.2667; DOI: https://doi.org/10.1370/afm.2667
Brian Kerley
1Niagara North Family Health Team, St Catharines, Ontario, Canada
2Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
MD, CCFP(PC), FCFP
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Lana Tan
2Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
3Kitchener Waterloo Community Palliative Care Team, Kitchener, Ontario, Canada
MD, CCFP(PC)
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Denise Marshall
2Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
4Niagara West Palliative Care Team, Grimsby, Ontario, Canada
MD, CCFP(PC), FCFP
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Cindy O’Neill
5Infection Prevention and Control Program, Hamilton Health Sciences, Ontario, Canada
MLT, ART, CIC
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Anne Bialachowski
6Infection Prevention and Control Program, St Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
RN, BN, MS, CIC
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José Pereira
2Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
7Pallium Canada, Ottawa, Ontario, Canada
MBChB, CCFP(PC), MSc, FCFP
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  • For correspondence: jpereira@mcmaster.ca
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Abstract

PURPOSE The safety of care professionals and patients is paramount while caring for people with infectious diseases, including those with confirmed or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19). Existing policies and protocols for donning and doffing personal protective equipment (PPE) are primarily for institutional settings such as hospitals, not for home visits for patient care. We describe a protocol for donning and doffing PPE in home settings.

METHODS We used an iterative, rapid-prototyping approach to develop the protocol. A small workgroup created preliminary drafts, drawing on hospital-based protocols and modifying them, while undertaking simulations. Wider input was solicited via 2 webinars; 1 regional (Hamilton, Ontario) with palliative clinicians, and 1 national (Canada) with varying professions. We also consulted a group of infectious disease experts. A “how-to” video accompanies the protocol.

RESULTS Twelve versions of the protocol were produced, with major changes occurring within the first 6 versions. A national webinar mid-development provided further validation and minor modifications. Subsequent versions involved minor changes. The protocol has 4 phases: (1) Preparing, (2) Entering the Home, (3) Leaving the Home, and (4) After the Visit and Reprocessing. In addition to PPE-related equipment, the protocol requires additional materials including 2 pails for transporting supplies, plastic bags, hand sanitizer, disinfectant wipes, and printed easy-to-use checklists.

CONCLUSIONS This protocol addresses gaps in COVID-19–related guidelines, specifically the process of donning and doffing PPE during home visits while supplementing jurisdictional PPE guidelines and protocols.

Key words:
  • personal protective equipment
  • home care
  • Received for publication August 11, 2020.
  • Revision received November 23, 2020.
  • Accepted for publication December 3, 2020.
  • © 2021 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 23 (2)
The Annals of Family Medicine: 23 (2)
Vol. 23, Issue 2
Mar/April 2025
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COVID-19 Personal Protective Equipment in the Home: Navigating the Complexity of Donning and Doffing
Brian Kerley, Lana Tan, Denise Marshall, Cindy O’Neill, Anne Bialachowski, José Pereira
The Annals of Family Medicine Feb 2021, afm.2667; DOI: 10.1370/afm.2667

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COVID-19 Personal Protective Equipment in the Home: Navigating the Complexity of Donning and Doffing
Brian Kerley, Lana Tan, Denise Marshall, Cindy O’Neill, Anne Bialachowski, José Pereira
The Annals of Family Medicine Feb 2021, afm.2667; DOI: 10.1370/afm.2667
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